SUMMARY NOTES IN THE RECORD s20271 (Duration: 23:43:59.988)
Starting time, recording date: 09:45:00 27/05/1992
Lead 0: 0
Lead 1: 1
Age: 61 Sex: M
Comments:
Records s20271, s20272, s20273 and s20274 are from the same patient.
This is the first record.
Lead 0:
This record shows multiple episodes of ischemia which
typically show T-wave peaking followed by significant
ST depression. Some episodes trigger the ischemic
episode definition during the ST elevation, while
others trigger only at the onset of ST-depression.
In still other cases there is a short interval of
"near-baseline" ST between the elevations (peaking
of Ts) and depressions which causes a double counting
of the biphasic episode as two separate episodes.
This occurs at: 6:41:32, 16:48:58, 18:33:00,
21:21:48, 21:36:10 and 23:36:22.
Physiologically each of these represents a single
episode of ischemia. At 15:18:52, there is a short
axis shift which interrupts the terminal portion of
an ischemic episode, resulting in artifactual early
termination of the ischemic episode, and the definition
of a second episode.
Lead 1:
At approximately 6:41:36 the terminal portion of the
ischemic episode is split into additional episodes -
but all represent the resolution phase of the ischemic
episode. T wave peaks, T-wave peaking decreases, and
finally ST depression resolve.
At 7:21:20, double positive peak in ST trend at beginning
of this episode is created by the superposition of
rate-related ST-depression. At 15:18:52, see note above
for lead 0. At the end of this record the data has a
number of episodes labeled as "rate-related".
At 16:52:48, axis shift annotation set between the end
of ischemic episode and local reference.
Electrode locations were not recorded.
Symptoms during Holter recording: No data
Diagnoses:
Coronary artery disease
Treatment:
Medications:
Isordil
Nitroglycerine
Calcium channel blocker
Aspirin
Balloon Angioplasty: Yes
Coronary Artery bypass Grafting: No
History:
Angina
Hypertension: No
Left ventricular hypertrophy: No
Cardiomyopathy: No
Valve disease: No
Electrolyte abnormalities: No
Hypercapnia, anemia, hypotension, hyperventilation: No
Atrioventricular nodal conduction delay: No data
Intraventricular conduction block: No data
Previous Myocardial Infarction: No
Previous tests:
ECG stress test: No data
Thallium/Stress echo: No data
Left ventricular function: No data
Echocardiogram: No data
Coronary Arteriography:
Lesions in left anterior descending coronary artery, left circumflex coronary artery
Baseline ECG: No data
Holter Recording:
Date: 27/05/1992
Recorder: No data
ST ANNOTATIONS
A. Criteria of 30 seconds and 75 microVolts (s20271.sta)
Lead 0:
Ischemic episodes: 63 Duration: 5:31:16 23.26%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 20
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 1:
Ischemic episodes: 62 Duration: 6:45:02 28.44%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 32
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Total:
Ischemic episodes: 125 Duration: 12:16:18 25.85%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 52
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined:
Ischemic episodes: 63 Duration: 7:06:52 29.98%
Rate-related episodes: 0 Duration: 0:00 0.00%
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined [ischemic or rate-related]:
ST segment episodes: 63 Duration: 7:06:52 29.98%
Unreadable intervals: 0 Duration: 0:00 0.00%
B. Criteria of 30 seconds and 100 microVolts (s20271.stb)
Lead 0:
Ischemic episodes: 52 Duration: 5:00:06 21.07%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 20
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 1:
Ischemic episodes: 56 Duration: 6:30:58 27.46%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 32
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Total:
Ischemic episodes: 108 Duration: 11:31:04 24.26%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 52
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined:
Ischemic episodes: 56 Duration: 6:46:32 28.55%
Rate-related episodes: 0 Duration: 0:00 0.00%
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined [ischemic or rate-related]:
ST segment episodes: 56 Duration: 6:46:32 28.55%
Unreadable intervals: 0 Duration: 0:00 0.00%
C. Criteria of 60 seconds and 100 microVolts (s20271.stc)
Lead 0:
Ischemic episodes: 51 Duration: 4:59:10 21.01%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 20
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 1:
Ischemic episodes: 54 Duration: 6:28:46 27.30%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 32
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Total:
Ischemic episodes: 105 Duration: 11:27:56 24.15%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 52
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined:
Ischemic episodes: 54 Duration: 6:44:20 28.39%
Rate-related episodes: 0 Duration: 0:00 0.00%
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined [ischemic or rate-related]:
ST segment episodes: 54 Duration: 6:44:20 28.39%
Unreadable intervals: 0 Duration: 0:00 0.00%
QRS ATRUTH ANNOTATIONS (s20271.atr)
Total number of beats 114201
Normal beats 106252
Premature ventricular contractions 7890
Atrial premature beats 38
Supraventricular premature or ectopic beats 1
Ventricular escape beats 3
Atrial escape beats 17